Basic Information
| Provider Information | |||||||||
| NPI: | 1407896566 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LIPTON | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | CANHAM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1746 COLE BLVD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804013208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039148800 | ||||||||
| FaxNumber: | 3037163777 | ||||||||
| Practice Location | |||||||||
| Address1: | 1746 COLE BLVD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804013208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039148800 | ||||||||
| FaxNumber: | 3037163777 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 12/18/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 2000-00877 | NC | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 52305 | CO | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | C9015 | 01 | NC | MEDCOST | OTHER | 131N5 | 01 | NC | BLUECROSS BLUESHIELD | OTHER | 16-01405 | 01 | NC | UNITED HEALTHCARE | OTHER | C8230 | 01 | NC | MEDCOST | OTHER | 16-01806 | 01 | NC | UNITED HEALTHCARE | OTHER | 16-01807 | 01 | NC | UNITED HEALTHCARE | OTHER | C9016 | 01 | NC | MEDCOST | OTHER | 3426230 | 01 | NC | AETNA | OTHER | P00164740 | 01 | NC | RAILROAD MEDICARE | OTHER | 891215N | 05 | NC | MEDICAID | P00108518 | 01 | NC | RAILROAD MEDICARE | OTHER |